Her gall bladder was removed in novembEr 2009 and she started paleo/primal in feb 2010 but despite eating better and taking probiotics she is still having digestive issues. Does anyone have info or links dealing with a person who had their gall bladder removed?
Arg, horrors! I have known people who have had the gallbladder out. Some of the docs would make you think you don't need it and all will likely be fine after. But many do suffer serious intestinal problems from that day forth. The big problem is the gallbladder is responsible for excreting bile to digest fat. No gallbladder and fat is much harder to digest. Also, sometimes the problem that the gallbladder removal was supposed to fix never ends up going away either.
This is such a tough one, but you may want to try eating really constant amounts of not too much fat. Keep the fat intake to smaller doses. Do not overload the body with fat all at once as fat digestion is now weakened. And stay clear of seed oils and fiber and whole grain and definitely stay away from wheat. Fiber and whole grain scratch the interior lining of the intestines and wheat causes all kinds of problems. Generally eat healthy of course. COnsider easy on the stomach things like pumpkin and banana if things are really going south. Of course, paleos tend to be in favor of eating fat, but with no gallbladder to help digest it, that advice may need to be altered at least to some extent.
Beyond that, you will want to keep a food log of all things ingested and how your digestion is doing. You will need to figure out which things trigger digestive problems so you can steer clear. And make food changes gradually. A sudden change can cause digestive disarray even if the new food would be a healthier one in the long run.
You could try stopping the probiotics. Doenst help everyone, was terrible terrible effect for me.
Also something to coat the gut lining can help it heal - things like gelatin (home made jelly), bone broth (gelatin+glutamine), slippery elm (mucous like stuff) etc...
Glutamine can also help gut repair.
And as I mentioned below, some people supplement with bile salts, once they have had their gallbladder removed to help digest fats. Not sure how well that works.
I also find cold stuff, like ice can help settle things down.
Sadly, alot of people have ongoing digestive issues after gallbladder removal.
My wife also had her gall bladder out, and immediately afterwards and for a year or two later she had some disestive issues. She is now sensitive to eating fatty foods. I am paleo but she is not but she avoids things like cream and fatty meats, says she just doesn't care for them any more and they can trigger disestive problems.
The gall bladder of course helps to digest fat so this kind of makes some sense.
Eating low fat paleo can be a little tricky depending on your appetite (i would have trouble with it) but could work. You could try different kinds of foods and fats (coconut cream, avocado, egg yolks, dairy) and see if she tolerates some better than others. My wife has no problem with avocado for example but can't do dairy fat.
See my answer to this question: http://paleohacks.com/questions/126030/digestive-enzyme-brands/132913#132913
Without a gallbladder, she'll need digestive enzymes to help process the fats properly. Going low fat is not a good idea. Also, using coconut oil where possible will help because about half of it is MCT oil, it won't require bile to process and has wonderful positive effects on the body.
The initial few months after the surgery will be hard because there's a lot of adjustment. The way this thing works is that they remove the gall bladder and connect the bile directly to the stomach, so there's a constant drip of bile.
If she for some reason doesn't have an appetite, she may experience bile reflux and throw up bile (will be very bitter and look bright yellow). But apparently there's a link to this operation and colon cancer because all of this bile goes downstream and since it has nothing to process, it may attack the lining of the intestines. So avoid fats is not a good idea.
Eating some fat throughout the day is a better thing to do, but in small amounts, so it's spread out.
Supposedly, over time, the bile duct becomes a rudimentary gall bladder, but it won't have the same capability as before.